One hundred one patients with
peripheral vascular disease of the lower extremity were entered into a study of the efficacy of oral
pentoxifylline to determine if the response to
therapy varied with the severity of disease. Ninety-three patients were evaluated before and after 8 weeks of
therapy with
pentoxifylline, while 8 did not complete the entire course due to
adverse drug reactions. Resting and post-stress ankle/arm Doppler indices (AAIs) were measured and, in those patients who could walk on a treadmill, treadmill walking distances were measured. Patients were classified according to pretreatment clinical and treadmill measurements and according to pretreatment resting AAIs. Resting and post-stress AAIs, as well as treadmill walking distances, increased in patients with moderately severe claudication. Patients in this group responded better to
therapy than did patients with rest
pain or ischemic
ulcers, severe claudication, or mild claudication. Patients with a pretreatment resting AAI greater than or equal to 0.5 responded better than those with an AAI less than 0.5. Only 5% of patients reported satisfaction with the results of treatment. These results support the findings that
pentoxifylline may be useful only in selected patients with moderately severe
peripheral vascular disease of the lower extremity and may not be useful in those with severe or mild disease.